Completed pilot on Pharmaceutical Pollution Prevention in Philadelphia.

In response to growing concerns about pharmaceutical compounds found in drinking water, Women's Health & Environmental Network (WHEN) launched a pilot project in 2008 that diverted mediations from wastewater through the first-in-the-nation mail-in of unwanted, unused and expired medicines from the elderly to a reverse distributor.  The pilot served as a proof of concept project testing the feasibility of mail-in programs, working with underserved communities on pharmaceutical stewardship, and the need for a comprehensive approach that focuses on upstream measures.

This Philadelphia Pilot intentionally worked with the senior population given its use of 4-12 medications a day for various chronic illnesses and the decades-old instruction of flushing unwanted medications. Results of the Pharmaceutical Pollution Prevention Pilot Project include:

- 142 non-controlled medications, valued at over $6,300, were diverted from wastewater. 

- The primary reasons given for disposal were expired and unused or doctors had ordered new medication. 

- Of the pharmaceuticals used among more chronically ill seniors were antidepressants, anticonvulsants, cholesterol-lowering drugs, over-the-counter analgesics, and cold medicines.  Other medications included high-blood pressure, antibiotics, and digestive aides. 

- Eight drugs were antidepressants that may have estrogenic properties when wildlife is exposed to them in the water.  Three were asthma drugs containing steroids that may alter gender in wildlife.  Two medications were chemotherapy agents that are categorized as “toxic” and may have hazardous effects on aquatic life. 

Small-scale mail-in assistance programs net a significant amount of medications that people are storing in their homes.  The removal of these medications is significant for pollution protection and for reducing the opportunity for unintentional use to drugs by children, teens and seniors.  There is an opportunity for additional educational programs to inform and instruct on proper disposal methods using guidelines provided by White House Office of National Drug Control Policy.

This pilot project demonstrates the need for safer pharmaceutical stewardship.  An increasingly aging population with one or more chronic diseases will continue to challenge society through its usage of high volumes of medications.  Children are becoming large-scale users of medications through both the increased prescribing practices for conditions such as ADHD and childhood diabetes and through illegal practices of “pharm” parties.  There is a clarion call for additional programs to enable people to divert unwanted/expired/unused medications from the waterways.  Improved risk communications to the public need to be developed and implemented to facilitate greater compliance with safer pharmaceuticals disposal.  By engaging all parties, we can protect the health of people, wildlife and our drinking water. 

Download the executive summary.